title: Training family members to manage heroin overdose and administer naloxone: randomized trial of effects on knowledge and attitudes.
abstract: OBJECTIVE
  To evaluate a heroin overdose management training programme for family members based on emergency recovery procedures and take-home naloxone (THN) administration.
  
  
  METHODS
  A two-group, parallel-arm, non-blinded, randomized controlled trial of group-based training versus an information-only control.
  
  
  METHODS
  Training events delivered in community addiction treatment services in three locations in England.
  
  
  METHODS
  A total of 187 family members and carers allocated to receive either THN training or basic information on opioid overdose management (n = 95 and n = 92, respectively), with 123 participants completing the study.
  
  
  METHODS
  The primary outcome measure was a self-completion Opioid Overdose Knowledge Scale (OOKS; range 0-45) and an Opioid Overdose Attitudes Scale (OOAS; range 28-140) was the secondary outcome measure. Each group was assessed before receiving their assigned condition and followed-up 3 months after. Events of witnessing and managing an overdose during follow-up were also recorded.
  
  
  RESULTS
  At follow-up, study participants who had received THN training reported greater overdose-related knowledge relative to those receiving basic information only [OOKS mean difference, 4.08 (95% confidence interval, 2.10-6.06; P < 0.001); Cohen's d = 0.74 (0.37-1.10)]. There were also more positive opioid overdose-related attitudes among the trained group at follow-up [OOAS mean difference, 7.47 (3.13-11.82); P = 0.001; d = 0.61 (0.25-0.97)]. At the individual level 35 and 54%, respectively, of the experimental group increased their knowledge and attitudes compared with 11 and 30% of the control group. During follow-up, 13 participants witnessed an overdose with naloxone administered on eight occasions: five among the THN-trained group and three among the controls.
  
  
  CONCLUSIONS
  Take-home naloxone training for family members of heroin users increases opioid overdose-related knowledge and competence and these benefits are well retained after 3 months.
authors.affiliation: Addictions Department, Institute of Psychiatry, King's College London, London, UK.
authors.forename: Anna V
authors.initials: AV
authors.lastname: Williams
authors.forename: John
authors.initials: J
authors.lastname: Marsden
authors.forename: John
authors.initials: J
authors.lastname: Strang
mesh_terms: D000328:Adult; D017028:Caregivers / Q000193:education* / Q000523:psychology; D062787:Drug Overdose / Q000517:prevention & control; D004739:England; D005190:Family / Q000523:psychology; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D003932:Heroin / Q000506:poisoning*; D006556:Heroin Dependence / Q000150:complications; D006701:Home Nursing / Q000193:education; D006801:Humans; D008297:Male; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone; D003932:Heroin
keywords: Attitudes; family members; heroin; knowledge; naloxone; opioid; overdose; randomized; trial